Two cases of double gall bladder

Comments And Summary

When a clinical diagnosis of a diseased gall bladder has not been verified by cholecystography, the following theoretical possibilities might occur: In the first situation, operation reveals a diseased gall bladder which is removed; an anomaly is not thought of; a supernumerary viscus may still be present, and may be entirely overlooked. If the accessory organ should be diseased the results would be serious. In the second situation, a normal gall bladder is found at operation in its conventional site. Again an anomaly is not thought of. An accessory gall bladder may therefore still be the seat of trouble. The cases of Wischnewsky and Braun demonstrate some of these points; neither case was X-rayed pre-operatively, in both the bladders were separated from each other, one being normal, the other diseased. Fortunately both organs were revealed at operation.

On the other hand, if cholecystography is performed it should be borne in mind that since a diseased gall bladder may coexist with a normal accessory gall bladder, the former may not be visualized, while the latter would reveal a normal sequence.

This finding might lead to a wrong negative diagnosis, with the result that an unsuspected active lesion might be overlooked. In short, the possibility of an accessory gall bladder should always be borne in mind both pre-operatively and post-operatively.